The ratio of ApoB to LDL-C increased as LDL-C decreased, consistent with small, dense particle prominence at lower LDL-C levels. ApoB measurement may identify a substantial proportion of pts with lower LDL-C who have persistently elevated atherogenic particle numbers.
Have you seen this ApoB/LDL-C ratio increase in your patients who have achieved an LDL in the 20s.
Does it concern you that at low LDL levels the remaining LDL particles may be smaller?
Do you care about the ratio if your patients are able to get their ApoB below 60?
I have asked my primary care physician to do my ApoB at my last 2 annual exams and he refuses. I am a 61 year old, female, overweight by 35 lbs with visceral fat, med controlled hypertensive on statins for hypercholesterolemia , A1C 5.7. My 56 yr old brother just had a major MI. I am aggressively implementing dietary/exercise lifestyle changes. So frustrating to be dismissed by my GP.
I an Asian that has a strong family history of atherosclerotic heart disease. My blood pressure is well controlled (<120/75) and my LDL is 32 on Crestor and Zetia. Do you see any obvious benefit to measuring Apo B.
Do you have patients who are not convinced enough to alter their lifestyle by a standard lipid panel, but are convinced enough to do so by a high apoB number?
https://www.jacc.org/doi/epdf/10.1016/S0735-1097%2823%2902266-0 March 2023 JACC
The ratio of ApoB to LDL-C increased as LDL-C decreased, consistent with small, dense particle prominence at lower LDL-C levels. ApoB measurement may identify a substantial proportion of pts with lower LDL-C who have persistently elevated atherogenic particle numbers.
Have you seen this ApoB/LDL-C ratio increase in your patients who have achieved an LDL in the 20s.
Does it concern you that at low LDL levels the remaining LDL particles may be smaller?
Do you care about the ratio if your patients are able to get their ApoB below 60?
Thanks. I think your substack letter is great!
Hey Doc thanks for your article. Top ressources
If I understand well, we should be lowering our ApoB level below 60 mg/dl.
Is nutrition modification may be sufficient to reach these goal ( with reduction of satured fats, more of fiber...) or medication is required?
At what age should we start taking statins if the ApoB level is in the 50 percent range?
Thank's
Another great article Doc. Do statins reduce the ApoB if VLDL is procured primarily in the Liver ?
Thanks got another informative article. If APOB is high, can anything be done about it to reduce risk?
If it’s not routine to check - are bought tests (on line) accurate enough to check for the APOB levels? And if so which ?🙏
Thank you!
I have asked my primary care physician to do my ApoB at my last 2 annual exams and he refuses. I am a 61 year old, female, overweight by 35 lbs with visceral fat, med controlled hypertensive on statins for hypercholesterolemia , A1C 5.7. My 56 yr old brother just had a major MI. I am aggressively implementing dietary/exercise lifestyle changes. So frustrating to be dismissed by my GP.
I an Asian that has a strong family history of atherosclerotic heart disease. My blood pressure is well controlled (<120/75) and my LDL is 32 on Crestor and Zetia. Do you see any obvious benefit to measuring Apo B.
Excellent article (again), thank you! I'm genuinely curious:
Do you order an apoB test for all your patients?
Do you have patients who are not convinced enough to alter their lifestyle by a standard lipid panel, but are convinced enough to do so by a high apoB number?